Cleveland Clinic in Strong Financial Health

In 2011, Cleveland Clinic marked its 90th anniversary in robust fashion, seeing a record number of outpatient visits, improving patient care through clinical and research achievements, opening new outpatient health and surgery centers, and enhancing the system’s already-sound financial health.

In his annual “State of the Clinic” address, Cleveland Clinic CEO and President Delos M. “Toby” Cosgrove, MD, reported that the health system’s total revenue in 2011 increased 5 percent over 2010, reaching $6.18 billion. Operating income rose 22 percent to $305 million, and investments were up 10 percent, reaching $4.3 billion.

“Our finances have never been stronger,” Dr. Cosgrove said. “We are positioned in a great way to continue to provide world class care to all the communities we serve – here in the Cleveland area and worldwide – while also providing the financial strength to deal with the increasing challenges facing all hospitals today.”

The challenge now is to maintain a strong fiscal presence in the face of decreasing reimbursements, a national trend toward declining inpatient stays, the local trend of a shrinking population in and around Cleveland, and growing pressure to cut healthcare costs.

Though Cleveland Clinic’s market share increased 2 percent in 2011 and outpatient visits reached a record 4.6 million, it is imperative to look beyond local markets, Dr. Cosgrove said. Some successful approaches have included: consulting and affiliation agreements across the country, which have included the Heart & Vascular Institute, Taussig Cancer Institute and the Neurological Institute; distance health and telestroke programs; and mergers and acquisitions, which in recent years have included Medina Hospital and North Coast Cancer Care in Sandusky.

“We must look seriously at mergers and acquisitions, which increase the scale and efficiency of the organization, increase the scope of what we can accomplish, and improve the skill-level of employees we are able to attract,” Dr. Cosgrove said. “Even as a non-profit hospital, growth and revenues are imperative. No money means no mission. Revenue and growth build financial strength, increase our relevance, create opportunities and attract talent. All of which strengthens the organization.”

Locally in 2011, services in East Cleveland transitioned from inpatient care at Huron Hospital to out-patient care at the Stephanie Tubbs Jones Health Center. New outpatient health and surgery centers were opened in Twinsburg and Avon.

In patient care, heart failure re-admissions dropped significantly, from more than 125 a month to about 60 per month. Central line blood infections were down from 8 percent in 2009 to less than 2 percent in 2011. More than 95 percent of inpatients were discharged with scheduled follow-up appointments. In an effort to broaden access to care, same-day appointments are now offered to all patients, with more than 1 million same-day visits scheduled in 2011.

Research and innovation continue to be highly valued at Cleveland Clinic. In 2011, researchers in the Lerner Research Institute published nearly 1,400 journal articles, an increase of 3 percent over 2010. Research achievements included: the first head-to-head comparison of popular statin drugs; the finding that a less expensive medication can treat macular degeneration as effectively as a much more expensive drug; and the identification of genes associated with esophageal adenocarcinoma and Barrett’s esophagus. Drs. Joseph Iannotti and Wael Barsoum were given the Sones Innovation Award for their development of innovative software and bone-modeling techniques for orthopedic implants.

Clinically, Cleveland Clinic caregivers ensured that innovations reached patients through the use of electrical stimulation for migraine and cluster headaches, by performing the first single-port robotic gall bladder surgery, and by offering a new drug combination to treat high-risk myelodysplastic syndrome.

In 2011, we successfully lowered healthcare costs. For example, the cost of a prostatectomy at Cleveland Clinic dropped by 23 percent, through a thorough review of surgical details and a shorter recovery time in the hospital. Also, 5,500 lab tests were halted to eliminate redundant or unnecessary tests.

Charity and uncompensated care rose 8 percent to $550 million in 2011.

The next several years will be influenced heavily by implementation of healthcare reform legislation. A move to new reimbursement models will undoubtedly impact the bottom line. By 2016, Cleveland Clinic expects to see a $237 million reduction in revenue due to federal reforms.

“We are in a period of enormous change within healthcare,” Dr. Cosgrove said. “The one constant is our focus on the patient and to do what’s right for the patient at all times. That is where we get our satisfaction. That is where we get out motivation. If we keep patients first and foremost in our minds, we will ultimately be successful regardless of what is handed to us.”

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,800 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. Cleveland Clinic Health System includes a main campus near downtown Cleveland, eight community hospitals and 18 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2013, Cleveland Clinic Abu Dhabi. In 2010, there were 4 million visits throughout the Cleveland Clinic health system and 167,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at www.clevelandclinic.org. Follow us at www.twitter.com/ClevelandClinic.